Racial Disparities in Senior Care Might Mean Separate and Unequal

By Carol Forsloff, Digital Journal

March 11, 2009

Grandpa died, and Grandma's frail. The family prepares Grandma for assisted living, since after all the parents work. On another side of town a family of a different color is sorting out work schedules to take care of Grandma.
There's a black and white difference between these two families in caring for seniors.

Walk into many independent living centers in America, as I have as a life care planner; and you will find African Americans on the service staff, nurses, nurse aids or custodial workers, but you won't find many seniors living there. If you do, they are bunched together in a few rooms. In independent living centers, like the one in Natchitoches, Louisiana there are no black seniors at all in spite of the fact that the town of 18,000 is evenly divided between blacks and whites. A local resident told me, “we don't put our folks away while they can still move around.” She's African American and 74 years old and definite about her statement. Nursing homes are different, however, she agreed. That's when people need the most care. But she told me African Americans are in the poor areas where nursing homes aren't as good. It turns out her observation is supported by research on the issue. 

What I have found in reviewing news and features on the subject of senior care is that there are African Americans in assisted living, but most are near the nursing home stage and live in all-black, poor communities. 40% of African Americans in nursing homes live in the lower level facilities and only 9% of whites, so there is serious discrepancy between the races at the level of nursing care. 

There are concerns about this issue, given the racial disparity in nursing homes. Nursing home facilities that care for African American communities tend to to be located in rural areas, admit people with mental retardation and movement problems. They have also been found to receive lower ratings of cleanliness, maintenance and lighting than white facilities. 

Not only are there disparities in nursing homes but in end-of-life care as well. In a recent study this year it was found that among 41,000 terminal cancer patients examined for the Beth Israel Deaconess Medical Center study, black patients constituted only 9% of the hospice program. This is in spite of the fact that 26% were likely to be hospitalized more often during the last few months of life than whites. Blacks were also more likely than whites to die in hospitals. Some studies have found black patients aren't as receptive to hospice care as white patients, but studies note there needs to be an examination of why that phenomenon exists. 

Perhaps, given the information provided by studies on nursing home and hospice care, there should be a Brown Vs. XYZ Nursing Home to trigger a response to provide equal treatment and facility care for seniors.

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